Bhramari Pranayam Versus Physical Exercise In The Management Of Insomnia: An Open Randomized Contolled Trial

SUMIT SRIVASTAVA
Government Ayurved College, Nagpur,India

29 June 2011

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Summary

Abstract :
Maximum number of patients (26.7%) suffering with insomnia were found in 40-45 years age group, married females.83.3% patients were taking sleeping pills. Significant changes found in associated symptoms like headache, body ache, confusion, irritation etc.

Keyword :
Bhramari pranayam, Insomnia

Introduction :
Bhramari (Humming Bee Breath) - In this Pranayam one has to make sound like humming bee while exhalation and inhalation as well. This Pranayam increases psychic sensitivity and awareness of subtle sound vibrations; this proves to be useful for Nada Meditation. 3 This is useful in removing stress and mental problems like anger, depression, anxiety etc. Bhramari Pranayam has positive effects on the endocrine system, immune system and nervous system.
Keeping above ideas in mind the emphasis has been made to study the efficacy of bhramari pranayam in the management of insomnia.

Discussion :
In this study, out of total 30 patients, 15 patients practiced physical exercises like cycling, running, walking etc. as negative control. Follow up of 30 days clearly shows efficacy of bhramari pranayam.

Conclusion :
In conclusion, on the basis of beneficial effects of bhramari pranayam in the literature and our own results of study in the context of insomnia, bhramari pranayam is effective in reducing associated symptoms of insomnia; however, significant changes in objective criteria's like total sleep duration, S. E. I. and S. L. I. may occur with regular and longer duration practice of bhramari pranayam.

Abstract :
Sleep is a very important support to health. Sleep holds a unique value for Health and can be even considered as one of the boons which God has given to Human beings. Natural sleep gives complete rest to the body and mind and provides psychic energy and enthusiasm. Our physical and mental health depends a great deal on sleep. In ayurvedic text sleep has been mentioned as tray-upstambh (sub pillars). In our country, the rule of 'early to bed and early to rise' has been followed traditionally. However, this practice has been very adversely affected by the fast pace of urbanization and industrialization.

PRANAYAM is the control of the dynamic aspect of the body. Bhramari (Humming Bee Breath) is an excellent breathing technique which proves to be useful for Nada Meditation. Bhramari Pranayam has positive effects on the endocrine system, immune system and nervous system. Keeping above ideas in mind the emphasis has been made to study the efficacy of bhramari pranayam in the management of insomnia.

Present study was conducted on 30 patients with the symptoms of insomnia, sleep efficiency scale <80% and sleep latency index >30min.coming in the O.P.D. /I.P.D. of Governmennt Ayurveda Hospital, Nagpur and its periphery. Patients were divided randomly into two groups (A, B) irrespective of age, sex and socioeconomic status. First group patients were practiced bhramari pranayam regularly for 30 days followed by relaxation process. Second group patients were put on physical exercises only. Patient having any severe vital illness were excluded. Maximum number of patients (26.7%) suffering with insomnia were found in 40-45 years age group, married females.83.3% patients were taking sleeping pills. Significant changes found in associated symptoms like headache, body ache, confusion, irritation etc.
So, Bhramari pranayam is effective in reducing the associated symptoms but total sleep time, S.E.I. and S.L.I. do not change significantly.

Keyword :
Bhramari pranayam, Insomnia

Introduction :
Insomnia is the most common sleep complaint both in the general population and in various medical and psychiatric patient populations. Studies in recent years have shown typical prevalence rates of about one-third in randomly selected adult populations.

Insomnia reflects the perception of inadequate sleep duration, continuity, or quality, or of difficulty with sleep initiation. Patients may report that their sleep difficulty may always occur at sleep onset, or in the middle or later hours of the night, or may be disturbed in a variable pattern that is unpredictable.

Gallop and polls data showed that patients with insomnia report significantly impaired concentration during the day, 1 have greater difficulty coping with minor irritations, experience a reduced ability to enjoy family and social relationships and were even 2.5 times more likely than noninsomnics to report having had a fatigue - related automobile accidents. Patients with insomnia are more likely to report poor health and to experience fatigue and depression. Research has also shown that by being chronically sleep deprived, one is shortening their life.

Prana is vital energy and ayama is control and extension of the Pranic energy. 2 Swami Swatmarama in Hatha Yoga Pradipika talks about Pranayam as the way to awaken the kundalini, regular practice of Pranayam can lead to spiritual awakening and self realization.

Considering the physiology of Pranayama, it can be classified as hyperventilation and hypoventilation. Mainly Kapalbhati, and Bhasrika Pranayama are considered as Hyperventilation type of Pranayama, this type of Pranayama revitalizes body. Bhramari, Shitali, Sitkari, Ujjayi etc. are considered as hypoventilation.

Bhramari (Humming Bee Breath) - In this Pranayam one has to make sound like humming bee while exhalation and inhalation as well. This Pranayam increases psychic sensitivity and awareness of subtle sound vibrations; this proves to be useful for Nada Meditation. 3 This is useful in removing stress and mental problems like anger, depression, anxiety etc. Bhramari Pranayam has positive effects on the endocrine system, immune system and nervous system.

Keeping above ideas in mind the emphasis has been made to study the efficacy of bhramari pranayam in the management of insomnia.

Methods : Criteria for selection of Patients :
Subjective criteria: i) Patients having complaint of inadequate sleep duration, continuity or quality or of difficulty with sleep initiation for more than 7 days.

Pathological investigations :
Routine pathological investigations of blood, urine and stool were done to rule out other pathological conditions and to observe any changes if occurs.
Statistical analysis :
For statistical analysis of symptoms before and after gradation of symptoms like 0, 1, 2, 3 in accordance of severity of symptoms was done. Data was analysed statistically by wilcoxon matched pairs signed rank test and paired t test.

Patients were randomly divided into two groups i.e. group A (experimental) and group B (negative control)

Group A patients practiced bhramari pranayam for 30 days regularly for the duration of 10 minutes followed by relaxation of 5 minutes each day.

Assessments of results were done on the basis of change in grades of symptoms, total sleep time, S.L.E., S.E.I.

Technique of Bhramari Pranayam :

Patients were instructed to sit in a comfortable posture and bring their hands up to ears, with the elbows pointed out to the side / downwards and plug the ears with the index fingers or just press the earflaps. Bring the awareness to the eyebrow centre. Inhale deeply through the nose and as they exhale, made a smooth and steady buzzing sound from the neck via the nose in the nasal passages. At the end of the exhalation they took a long deep breath in and repeat the process.
Observations and results : Table 1.1
showing total sleeps time of 30 patients of insomnia

Total sleep time

Frequency

Percent

Cum Percent

1 hr

1

3.3%

3.3%

2 hr

20

66.7%

70.0%

3 hr

9

30.0%

100.0%

Total

30

100.0%

100.0%

Discussion :
Sleep ( Nidra ) is a dynamic process which occurs naturally in humans in either one long nocturnal period or in a nocturnal period and a afternoon period. Studies in recent years have shown typical prevalence rates of about one - third in randomly selected adult populations.

In spite of all sorts of advancements of science, in this world, man is not able to sail himself in the boat of happy and healthy life. Unnatural ways of life style, increased population and moreover world of machines has created unlimited desires in human mind on the one hand, while on the other hand, it has originated anxiety, anger, hostility and grief directly or indirectly. So many diseases are there which output of unnatural dietary habits, restless lifestyle is and stress, one of such is insomnia.

The portion of the nervous system that controls the visceral functions of the body is called the autonomic nervous system. The autonomic nervous system is activated by centres located in the spinal cord, brainstem, and hypothalamus. Portions of the cerebral cortex, especially of the limbic cortex, can transmit impulses to the lower centres and in this way influence autonomic control. The different autonomic signals are transmitted to the body through two major subdivisions called the sympathetic and parasympathetic nervous system. Sympathetic nervous system has an active pushing function; the parasympathetic has mainly a relaxing function. When the sympathetic nervous system over stimulates, it results in numerous adverse physiological changes such as anxiety, panic attack, stress and increased blood pressure. People with insomnia problem must have noticed that whenever they want to sleep, their mind becomes more active and lots of thoughts, programmes etc. start coming into their mind and they find difficulty to fall asleep. To counter these changes, we should follow certain techniques to activate the parasympathetic nervous system. The parasympathetic nervous system counteracts the stress effect, calming you down, slowing heart rate, increasing digestion, and so on. While making a buzzing sound, we get vibrations in the brain which create a soothing effect on the mind and the nervous system. It stimulates the parasympathetic nervous system, which induces muscular, physical, mental and emotional relaxation. Bhramari pranayam vibrates the whole brain. Vibration of the cerebral cortex sends impulses to the hypothalamus which has the capacity to control the pituitary gland - the master of all glands.

In this study, out of total 30 patients, 15 patients practiced physical exercises like cycling, running, walking etc. as negative control. Follow up of 30 days clearly shows efficacy of bhramari pranayam.

Conclusion :
In conclusion, on the basis of beneficial effects of bhramari pranayam in the literature and our own results of study in the context of insomnia, bhramari pranayam is effective in reducing associated symptoms of insomnia; however, significant changes in objective criteria's like total sleep duration, S. E. I. and S. L. I. may occur with regular and longer duration practice of bhramari pranayam.